Abstract Circulating microRNAs miRNAs may play an important role in pathogen-host interactions and can serve as molecular markers for the detection of infectious diseases. To date, the relationship between circulating miRNAs and varicella-zoster virus VZV caused varicella has not been reported. Using TaqMan Low-Density Array TLDA analysis, expression levels of miRNAs in serum samples from 29 patients with varicella and 60 patients with Bordetella pertussis BP, measles virus MEV and enterovirus EV were analyzed. The array results showed that 247 miRNAs were differentially expressed in sera of the varicella patients compared with healthy controls 215 up-regulated and 32 down-regulated. Through the following qRT-PCR confirmation and receiver operational characteristic ROC curve analysis, five miRNAs miR-197, miR-629, miR-363, miR-132 and miR-122 were shown to distinguish varicella patients from healthy controls and other microbial infections with moderate sensitivity and specificity. A number of significantly enriched pathways regulated by these circulating miRNAs were predicted, and some of them were involved in inflammatory response, nervous system and respiratory system development. Our results, for the first time, revealed that a number of miRNAs were differentially expressed during VZV infection, and these five serum miRNAs have great potential to serve as biomarkers for the diagnosis of VZV infection in varicella patients. View Full-Text